How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $44.67 Median $125.89 Typical High $141.25 | Facility | None | $44.67 | $125.89 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | None | $44.67 | $44.67 | $46.77 |
BCBS Michigan Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $263.03 | Facility | None | $75.86 | $91.20 | $263.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $13.18 | Professional | None | $11.22 | $12.02 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $173.78 Typical High $173.78 | Professional | None | $47.86 | $173.78 | $173.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $123.03 Median $141.25 Typical High $426.58 | Facility | None | $123.03 | $141.25 | $426.58 |
Health Alliance Plan Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $77.62 | Professional | None | $44.67 | $52.48 | $77.62 |
Priority Health Setting Professional Modifier None Typical Low $47.86 Median $173.78 Typical High $173.78 | Professional | None | $47.86 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | None | $46.77 | $46.77 | $63.10 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $22.39 Typical High $69.18 | Professional | 52 · Reduced service | $22.39 | $22.39 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $27.54 | Professional | 53 · Discontinued | $8.91 | $8.91 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $20.89 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $13.80 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $10.72 Median $11.22 Typical High $11.75 | Professional | JW · Drug discarded | $10.72 | $11.22 | $11.75 |
Where Michigan sits
The same service costs 3.9 times more in Hawaii than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 22nd of 51
$54.95
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.